Table 4 Description of missed injuries
From: The effect of tertiary surveys on missed injuries in trauma: a systematic review
Author, year, origin, N | (N)with MI | Area involved | % | (N)with clinically significant MI | Description of change in management | Mortality and morbidity |
|---|---|---|---|---|---|---|
Enderson, 1990, Tennessee, USA N=399 | 36 | MSK | 51 | 7 | OT, N= 7 | Nil deaths |
Spinal | 12 | (MSK N=3, Facial N=1, Abdomen N=3) | Stroke, N=1 | |||
Facial | 5 | |||||
Thoracic | 12 | |||||
Abdominal | 15 | |||||
Vascular | 5 | |||||
Biffl, 2003, | 81 vs. 52 | MSK | 32 vs. 46 | Not reported | Not reported | Not reported |
Rhode Island, USA | Spinal | 29 vs. 24 | ||||
Pre TTS: N= 3412 vs. Post TTS: 3442 | Abdominal | 17 vs. 18 | ||||
Brain | 10 vs. 6 | |||||
Pelvic | 5 vs. 0 | |||||
Vascular | 3 vs. 2 | |||||
Diaphragm | 3 vs. 0 | |||||
Vles, 2003, | 49 | Chest | 33 | 22 | OT, N=12 | Morbidity unspecified, N=3 |
The Netherlands N=3879 | MSK | 27 | (Chest N=1, MSK N=4, Facial N=5, Other N=2) | |||
Skull | 7 | ICC, N=2 | ||||
Facial | 13 | Cast, N=6 | ||||
C-Spine | 7 | |||||
Other | 10 | Halo/brace, N=2 | ||||
Hoff, 2004 | 42 | Extremities | 45 | 19 | OT, N=4 (not specified) | Not reported |
Pennsylvania, USA | Spine | 21 | Cast, N=7 | |||
N=432 | Chest | 15 | Transfer, N=1 | |||
Pelvis/proximal skeleton | 19 | Change in advice, N=6, Home equipment, N=1 | ||||
Soundappan, 2004 | 12 | Head/face | 33 | 1 | OT, N=1 (not specified) | Nil deaths |
Sydney, Australia | Spine | 17 | Prolonged LOS, N=4 | |||
N=76 | Extremities | 50 | Delay in mobilisation, N=4 | |||
Howard, 2006, | 13 | Extremities | 70 | Not reported | Not reported | Not reported |
Indianapolis, USA | Face | 12 | ||||
N=90 | Spine | 12 | ||||
Chest | 6 | |||||
Okello, 2007, | 76 | Head and neck | 24 | Not reported | Not reported | Not reported |
Uganda | Face | 8 | Mulivariate regression shows higher morbidity and longer LOS in patients with MI compared to patients without MI. This may not reflect causality. | |||
N=403 | Thorax | 11 | ||||
Abdomen/pelvis | 20 | |||||
Extremities | 26 | |||||
Janjua, 2008 | 134 | MSK | 40 | 30 | OT, N=11 (Orthopedic n=3, Laparatomy N=7, | Death 1.5% (N=2: C1 fracture; epidural hematoma) |
Sydney, Australia | STI | 36 | Thoracotomy N=1) | Complications 8% (peritonitis N=4 after missed hollow viscus injury) | ||
Abdomen | 6 | Laceration repair, N=2 | ||||
N=206 | Nerve injury | 9 | Embolisation, N=1 | |||
(Hemo-) Pneumothorax | 5 | Not specified, N=17 | ||||
Ursic, 2009 | 35 vs 62 | Not reported | Not reported | Not reported | Mortality | |
Sydney, Australia | Pre 3.5% vs. post 2.5% | |||||
Pre TTS: N=981 vs. Post TTS= 1006 | ||||||
Huynh, 2010 | 80 | Orthopedic | 60 | 31 | OT, N=7 (Orthopedic N=4, Facial N=2, Spinal N=1) | Not reported |
North Carolina, USA | Facial/plastics/dental | 21 | Cast, N=24 | |||
N=5143 | Neurosurgical | 16 | ||||
Ophthalmology | 3 |